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SHAD MORTENSEN DO
NPI 1568217644
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Active since April 22, 2024
2601 E ROOSEVELT ST, PHOENIX, AZ 85008(435) 695-4017 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 29, 2025, Apr 22, 2024 (2 updates tracked since 2024).

About Shad Mortensen Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAD MORTENSEN DO (NPI 1568217644) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since April 2024. He maintains 3 additional practice locations.

NPPES Registry Identity

NPI1568217644
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHAD MORTENSENCredential: DO
Location Address2601 E ROOSEVELT STPhoenix, AZ 85008-4973
Mailing Address3100 N Central AvePhoenix, AZ 85012-2637
Phone(435) 695-4017
Sole ProprietorNo
Enumeration DateApril 22, 2024
Last NPPES UpdateMay 29, 20252 updates tracked since enumeration
NPPES CertifiedMay 29, 2025
✔ NPI 1568217644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2601 E ROOSEVELT ST, Phoenix, AZ 85008
Open in Google Maps ↗

Secondary Practice Locations 3

Location 13100 N Central AvePhoenix, AZ 85012-2637 · Phone (435) 695-4017
Location 21625 N Campbell AveTucson, AZ 85719-4330 · Phone (520) 694-0111
Location 32800 E Ajo WayTucson, AZ 85713-6204 · Phone (520) 874-2000

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOEL PHILIP BETZ M.D.
Emergency Medicine (Emergency Medical Services)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5411
DR. ALI SHAHEEN AL-YAQOOBI M.D.
Internal Medicine
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5411
MARICOPA INTEGRATED HEALTH SYSTEM
General Acute Care Hospital
2601 E ROOSEVELT ST, DEPARTMENT OF MEDICINE
PHOENIX, AZ 85008
Maricopa County (602) 344-5366
OWEN THOMAS MCCABE MD
Surgery (Trauma Surgery)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
BRIGHAM NICOLL
Psychiatry & Neurology (Psychiatry)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
DR. AMELIA CATHERINE VAN HANDEL M.D.
Plastic Surgery
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (410) 999-0858
KEVIN YANG
Psychiatry & Neurology (Psychiatry)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
STEPHANIE BERKSHIRE DO
Internal Medicine
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5892

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shad Mortensen's NPI number?

The NPI number for Shad Mortensen is 1568217644. It was assigned to this individual provider in the NPPES registry on April 22, 2024.

Where is Shad Mortensen located?

Shad Mortensen practices at 2601 E Roosevelt St, Phoenix, AZ 85008. The listed phone number is (435) 695-4017.

What is Shad Mortensen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Shad Mortensen was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.